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What to do with a choking pet:

by PETS Referral Center on January 26, 2012

Having “something stuck in the throat” is a common problem due to our pets’ curious nature and indiscriminate eating habits. Many of you may remember Clover, the Bernese Mountain Dog, that got a little over exuberant while chewing and accidentally swallowed her tennis ball! This girl presented for difficulties with both swallowing and breathing, and x-rays revealed that her distress was from toy-induced turmoil.

True choking is actual interference with breathing caused by foreign material in, or compression on, the trachea (windpipe). Choking can occur due to an obstruction of the airway from a foreign object in the throat, severe swelling of the throat, orconstriction of the neck. True choking is an emergency and immediate veterinary assistance is crucial.

In the case of foreign objects

In order for the foreign object to cause choking, the object must obstruct the opening to the airway, whether this is directly (i.e., actually in the airway), or indirectly (i.e., compressing on the airway), as in the case of Clover. Clover swallowed the tennis ball, which means it entered the esophagus (the “swallowing tube”) instead of the trachea (the “breathing tube”), but the ball was large enough to cause compression on her trachea- which lives right above the esophagus- causing difficulty with her breathing.

As an aside, just having an object stuck in the mouth does not always result in the emergency condition associated with choking. One common oral foreign body that does not result in choking is associated with bone ingestion when they get stuck between teeth, around the lower jaw, or even on the roof of the mouth. This results in significant distress for the pet but is not “true” choking.

Other causes of choking

Severe throat swelling can cause choking and is usually associated with an allergic reaction or response to trauma. The tissues within the throat can swell so much that the opening to the airway is blocked.

Constricting neck injuries are usually associated with collars and ropes. Dogs and cats that get collars tangled can choke due to the constriction of the neck from the tightness of the collar. In severe cases, dogs and cats can hang from collars, leashes and ropes. For example, a dog may be tied to a leash with just enough slack to jump the fence but not enough slack to allow the dog to touch the ground on the other side.

Making matters worse…

A complication associated with choking is pulmonary edema, which is the accumulation of fluid within the lung tissue associated with neck injury. The exact reason this occurs is not completely understood. When the neck is constricted or the airway is blocked, it is thought that nerve stimulation in the neck results in fluid accumulation in the lungs, which can lead to difficulty breathing.

What to watch out for:

The following are common signs that owners will observe during a choking episode:

Drooling

Gagging

Difficulty swallowing

Difficulty breathing

Pawing at face

Regurgitation

Anxiety and distress

Diagnosis:

Choking is mainly diagnosed based on history and physical examination. For oral foreign bodies, an oral exam reveals the cause of the obstruction. In severely distressed animals, sedation is often required to examine the inside of the mouth as well as alleviate anxiety.

X-rays may be necessary to locate the area and size of the foreign object as well as to look for signs of pulmonary edema. The x-ray shown above is the actual image we took of Clover, which shows the distinct outline of the tennis ball in her esophagus.

Treatment:

For oral foreign bodies, the foreign object needs to be removed immediately. For Clover, this entailed removing the ball by endoscopy because it was too far down to remove by other means. The picture below shows the ball after its retrieval with the endoscope.

The tennis ball, after being snared with a specialized tool through an endoscope.

In severe cases that fully obstruct the ability to breathe, an emergency tracheostomy may be required. This is a temporary measure that allows the pet to breathe until the cause of the choking can be resolved. A small incision in the trachea is made to allow for the placement of a breathing tube directly into the trachea.

What to do while you are in route to veterinary care:

Home Care

If you notice that your pet is choking, remove any item that may be constricting the neck. If you can do it safely, examine the inside of the mouth and remove any foreign object you see, but do not attempt to remove an object unless you can see and identify it.

If you cannot easily remove the object, lift and suspend a small animal with the head pointed down. For larger animals, lift the rear legs so the head is tilted down (like a wheel barrow). This can help dislodge an item stuck in the throat.

Another method is to administer a sharp hit with the palm of your hand between the shoulder blades, which can sometimes dislodge an object.

If this does not work, a modified Heimlich maneuver can be attempted. Grasp the animal around the waist so that the rear is nearest to you, similar to a bear hug. Place a fist just behind the ribs. Compress the belly 3 to 5 times with quick pushes. Check the mouth to see if the foreign object has been removed.

If the Pet is Unconscious:

Perform a Finger Sweep: open your pet’s mouth and do a finger sweep by placing your finger along the inside of the mouth, sliding it down toward the center of the throat over the base of the tongue, and gently “sweeping” toward the center to remove any foreign material. Warning: there is a structure deep in the throat (the Adam’s apple) that feels like a smooth bone. Do not attempt to pull it out!

Below is a video that demonstrates the above techniques. Please note! All of these maneuvers should be attempted WHILE YOU ARE IN TRANSIT to a veterinary hospital for care!

Even if you are successful in removing a foreign object, veterinary examination is recommended. Internal injury could have occurred that you may not realize.

What else could it be?

More times than not, what people believe to be choking is actually attempts at vomiting or coughing. Many pet owners will seek veterinary care because they believe their pet has something stuck in its throat, however, it is far more likely that your pet has something mild and infectious such as tracheobronchitis (also known as kennel cough) and he or she is coughing rather than choking.

Here is a tip to help determine if your pet is choking versus coughing: with choking, the pet has difficulty inhaling; with coughing, the pet can inhale almost normally.

Preventative Care:

Here are a few tips to help prevent a trip to the ER:

Make sure your pet has a collar that fits properly. Tight collars can create serious injury.

Do not let your pet have sufficient slack in a tie out to allow jumping over fences or off of decks and patios.

Like human children, keep all choking hazards such as small items and toys, away from your pet; super balls and “mini” tennis balls for smaller breed dogs are also a common cause of upper airway obstruction in large breed dogs.

Clover and her experience prompted me to write this blog and I hope it will help prevent, or save, another pet in the future. Clover made a full recovery following the endoscopic removal of the tennis ball that she swallowed and she continues to do well!